Object: To treat hydrocephalus by ventriculo-peritoneal shunt operation, the correct positioning of the proximal catheter in the ventricle is very important. The purpose of this study was to develop the "shunt guiding kit" for the proper positioning of the proximal shunt catheter to the ventricle in the ventriculo-peritoneal shunt operation. MATERIALS AND METHODS: The "shunt guiding kit" is made of tungsten alloy and it consists of one frame, two screws and one guider. Through the guider, the proximal shunt catheter operates by mechanically coupling the posterior burr hole to the anterior target point. RESULTS: We have treated three hydrocephalus patients with use of the "shunt guiding kit", and achieved good location of proximal shunt catheters. CONCLUSION: We developed the "shunt guiding kit" for the proper positioning of the proximal shunt catheter to the ventricle, and this would be very useful for preventing ventriculo-peritoneal shunt malfunction and preventing possible brain injury during the procedures.
Alloys ; Brain Injuries ; Catheters* ; Humans ; Hydrocephalus ; Lateral Ventricles* ; Tungsten ; Ventriculoperitoneal Shunt*

Purpose: Total hip arthroplasty (THA) is performed using various approaches, including posterior, lateral, and direct anterior approaches.The most beneficial method is controversial. Each approach has its advantages and disadvantages. This study compared patient satisfaction after bilateral THA using the direct anterior and lateral approaches on the same patient, considering the advantages and disadvantages of each approach. Materials and Methods: This study examined 30 patients who underwent bilateral THA: two with femoral neck fractures, 18 with osteonecrosis of the femoral head, six with borderline dysplasia-induced hip osteoarthritis, and four with degenerative hip osteoarthritis.Without distinguishing between the left and right sides, THA was performed randomly using the direct anterior approach on one side and the lateral approach on the other. The results of THA were compared using different approaches on the same patient, and patient satisfaction was evaluated. Results: Surgery using the direct anterior approach for THA showed favorable results in terms of the initial postoperative pain compared to surgery using the lateral approach. On the other hand, there was no significant difference observed after one month post-surgery. Among the participants, three preferred the direct anterior approach; four preferred the lateral approach, and 23 reported no preference. Conclusion In THA, the direct anterior approach may offer advantages in terms of initial postoperative pain and rehabilitation compared to the lateral approach. Nevertheless, the pain and joint function one month after surgery were similar between the two approaches.Therefore, the choice of approach should be determined by the surgeon's preference or experience, as both methods appear rational.

Purpose: Total hip arthroplasty (THA) is performed using various approaches, including posterior, lateral, and direct anterior approaches.The most beneficial method is controversial. Each approach has its advantages and disadvantages. This study compared patient satisfaction after bilateral THA using the direct anterior and lateral approaches on the same patient, considering the advantages and disadvantages of each approach. Materials and Methods: This study examined 30 patients who underwent bilateral THA: two with femoral neck fractures, 18 with osteonecrosis of the femoral head, six with borderline dysplasia-induced hip osteoarthritis, and four with degenerative hip osteoarthritis.Without distinguishing between the left and right sides, THA was performed randomly using the direct anterior approach on one side and the lateral approach on the other. The results of THA were compared using different approaches on the same patient, and patient satisfaction was evaluated. Results: Surgery using the direct anterior approach for THA showed favorable results in terms of the initial postoperative pain compared to surgery using the lateral approach. On the other hand, there was no significant difference observed after one month post-surgery. Among the participants, three preferred the direct anterior approach; four preferred the lateral approach, and 23 reported no preference. Conclusion In THA, the direct anterior approach may offer advantages in terms of initial postoperative pain and rehabilitation compared to the lateral approach. Nevertheless, the pain and joint function one month after surgery were similar between the two approaches.Therefore, the choice of approach should be determined by the surgeon's preference or experience, as both methods appear rational.

Purpose: Total hip arthroplasty (THA) is performed using various approaches, including posterior, lateral, and direct anterior approaches.The most beneficial method is controversial. Each approach has its advantages and disadvantages. This study compared patient satisfaction after bilateral THA using the direct anterior and lateral approaches on the same patient, considering the advantages and disadvantages of each approach. Materials and Methods: This study examined 30 patients who underwent bilateral THA: two with femoral neck fractures, 18 with osteonecrosis of the femoral head, six with borderline dysplasia-induced hip osteoarthritis, and four with degenerative hip osteoarthritis.Without distinguishing between the left and right sides, THA was performed randomly using the direct anterior approach on one side and the lateral approach on the other. The results of THA were compared using different approaches on the same patient, and patient satisfaction was evaluated. Results: Surgery using the direct anterior approach for THA showed favorable results in terms of the initial postoperative pain compared to surgery using the lateral approach. On the other hand, there was no significant difference observed after one month post-surgery. Among the participants, three preferred the direct anterior approach; four preferred the lateral approach, and 23 reported no preference. Conclusion In THA, the direct anterior approach may offer advantages in terms of initial postoperative pain and rehabilitation compared to the lateral approach. Nevertheless, the pain and joint function one month after surgery were similar between the two approaches.Therefore, the choice of approach should be determined by the surgeon's preference or experience, as both methods appear rational.

No abstract available.
Carcinoma, Transitional Cell* ; Female ; Ovary

Influenza-associated encephalopathy is regarded as one of the major neurologic disease entities along with those of Reye syndrome, acute necrotizing encephalopathy, and myelitis which are known to be related to influenza virus, mostly type A. And it is being actively researched in Japan as it has caused a tremendous increase in the number of deaths from 1997 to 2002, but it has not been yet reported in the Korean pediatric medical community. It attacks those previously healthy children, who have not been vaccinated. Patients start with such symptoms as fever and common respiratory problems, but within 24 to 48 hours they suffer from seizures with acute mental deterioration, become worse, and suffer multiple organ failures including marked elevated transaminase levels as well as coagulopathy. It induces deaths in a couple of days after the symptoms appear or remains a serious neurologic sequelae. Confirmative diagnosis is used to demonstrate influenza viral infection. We report here a 37 month aged boy who was admitted to our hospital during the last influenza season under the diagnosis of influenza associated encephalopathy on the basis of serologic testing by hemagglutinin inhibition(HI). This is the first report confirmed by increased antibody titer of the influenza A virus in Korea.
Child ; Diagnosis ; Fever ; Hemagglutinins ; Humans ; Influenza A virus ; Influenza, Human ; Japan ; Korea ; Male ; Multiple Organ Failure ; Myelitis ; Orthomyxoviridae ; Reye Syndrome ; Seasons ; Seizures ; Serologic Tests

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.
Abdomen ; Female ; Humans ; Physical Examination ; Spleen* ; Surgical Instruments ; Ultrasonography ; Viola ; Young Adult

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.
Abdomen ; Female ; Humans ; Physical Examination ; Spleen* ; Surgical Instruments ; Ultrasonography ; Viola ; Young Adult

High peak inspiratory pressure during control-mode ventilation (CMV) with volume cycled ventilator is associated with increased risk of barotrauma. Pressure controlled ventilation can reduce peak inspiratory pressure and barotrauma, and provide for adequate gas exchange. We present a case of the patient of status asthmaticus in whom we used pressure controll ventilation of lower inspiratory pressure (initially 45 cmH2O) with good outcome during midazolam infusion. At the admission to the ICU, the peak inspiratory pressure was 80 cmH2O with control- mode ventilation of volume cycled ventilator and respiratory acidosis developed (pH: 7.20, PaCO2: 64.1 mmHg). After changing the volume control mode to pressure controlled mode, the peak inspiratory pressure could be reduced from 80 cmH2O to 45 cmH2O with improvement of respiratory acidosis. From our experience, we recommend the application of pressure control ventilation safely to the patients in whom peak inspiratory pressure is high enough to induce barotrauma, if expired tidal volume is monitored.
Acidosis, Respiratory ; Barotrauma ; Humans ; Midazolam ; Status Asthmaticus* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

OBJECTIVES: This study investigated lung function in workers exposed to dusts, fumes and noxious gases at small foundries. METHODS: Lung function was measured in 148 male workers from 12 small foundries and 202 unexposed male workers. Pulmonary function tests performed included: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), percent of FEV1/FVC (FEV1/FVC%), maximum mid-expiratory flow (MMEF), peak expiratory flow (PEF), and forced expiratory flow at 25, 50, and 75% of expired FVC (FEF25, 50, 75). RESULTS: Mean values of all ventilatory indices except FEF25 of foundry workers were significantly lower than those of controls. Specifically, following stratification by smoking habits, all ventilatory indices except FEF25 of foundry workers were significantly lower than those of controls who smoked; however, there were no significant differences observed in any ventilatory indices between nonsmoking exposed workers and controls. The results of multiple linear regression analysis indicated work duration as a significant predictor of a decrease in FVC%. CONCLUSIONS: This research indicates that combined occupational exposure to dust, fumes, and gases in small foundries is associated with a reduction in lung function. Smoking may also contribute to respiratory abnormalities. These results suggested that foundry workers should be required to undergo periodic lung function tests and-in addition to not smoking, efficient use of personal protection equipment while at work is recommended.
Dust ; Forced Expiratory Volume ; Gases ; Humans ; Linear Models ; Lung ; Male ; Occupational Exposure ; Respiratory Function Tests ; Smoke ; Smoking ; Vital Capacity